{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LANE K YEO","gend":1,"add":"7198 BROOKING WAY","city":"MECHANICSVILLE","state":"VA","zip":"23111-9998","dob":"1946-01-22","age":"","mstatus":"","insh":"11001603","cliId":"","pno":6502016291,"cno":"","email":"","ename":"","eno":"","pphy":"VARMA, KANIKA","ppno":8047463505,"pcpadd":"7041 LEE PARK RD","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":231113682,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS PRIMARY CARE ASSOCIATES - MECHANICSVIL","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"7198 BROOKING WAY","madd2":"","madd3":"","mcity":"MECHANICSVILLE","mstate":"VA","mzip":"23111-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","00085720601","DULERA ","100-5MCG","39.00","Select","Select",""],["","52817033010","CYCLOBENZAPR ","5MG","7.00","Select","Select",""],["","00378668999","PANTOPRAZOLE ","40MG","30.00","Select","Select",""],["","65862032904","ALENDRONATE ","70MG","12.00","Select","Select",""],["","59762040101","SUCRALFATE ","1GM","56.00","Select","Select",""],["","00713076640","TRIAMCINOLON ","DEN 0.1%","5.00","Select","Select",""],["","45802008801","ALBUTEROL ","HFA","8.50","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","90.00","Select","Select",""],["","00173069600","ADVAIR ","250\/50","180.00","Select","Select",""],["","55111012105","ATORVASTATIN ","10MG","90.00","Select","Select",""],["","00093077198","PRAVASTATIN ","10MG","90.00","Select","Select",""],["","59762033302","LATANOPROST ","0.01%","7.50","Select","Select",""],["","29300012510","MELOXICAM ","15MG","30.00","Select","Select",""],["","59310057922","PROAIR ","","8.50","Select","Select",""],["","70461012003","FLUAD ","0.5ML","0.50","Select","Select",""],["","00065026005","TRAVATAN ","0.00%","5.00","Select","Select",""],["","59746000103","METHYLPRED ","4MG","21.00","Select","Select",""],["","49281012165","FLUZONE ","2021-22","0.70","Select","Select",""],["","69238110005","DOXYCYCL ","100MG","20.00","Select","Select",""],["","00603533932","PREDNISONE ","20MG","21.00","Select","Select",""],["","65862001605","AMOXICILLIN ","250MG","40.00","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}